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Srotas Proforma
Purpose: To assess status of Srotodushti in different clinical conditions(Ref. C.Vi. 05)
Case No. 02 No. Rural /Urban Date : Resident Name of the Patient Socio Economic Status Lower Middle /Upper Sam nwddui sollkàe Address Prirtary/ HS /G /PG Ikheedi Education Occupation House woite Age 32 OPD No. 2812 Gender IPD No. 212 Femae Mobile No. Known case of
Present Complaints - days
Whether causative Type of Srotodushti
Srotas involved factors of the particular (Atipravrutti, Sanga, Interpretation Srotodushtiare present. Siragranthi, Vinarga absent (If yes give the gamana) details) Metu duo to ah'maata vinegagama LeUan vieoddhy ahaa thee is aama toemahen and 3160|d Sanga PueuoRpa Bala ksayo, Sanga NaUsee du Rasa kshine to Rasa l<swng